Systematic Review of Bilateral Benign Paroxysmal Positional Vertigo

Area of Science:

• Otolaryngology
• Neurology
• Vestibular Disorders

Background:

• Bilateral benign paroxysmal positional vertigo (BiBPPV) presents a diagnostic and therapeutic challenge.
• Canalith repositioning maneuvers (CRM) are a primary treatment for BPPV.

Purpose of the Study:

• To systematically evaluate the success rates of CRM in patients diagnosed with BiBPPV.
• To assess treatment outcomes, including success rates, number of treatments, and recurrence rates for BiBPPV.

Main Methods:

• A systematic review of English-language studies was conducted using PubMed, Ovid, and Embase up to January 1, 2021.
• Nine studies with 325 patients diagnosed with BiBPPV were included, assessing CRM success.
• The NIH Study Quality Assessment Tool was used to evaluate study bias.

Main Results:

• The overall success rate for CRM in BiBPPV was 95.2% (CI: 92.9%-97.5%).
• The mean number of treatments required was 2.9 (CI: 2.4-3.4), with a recurrence rate of 19.8% (CI: 11.7%-27.9%).
• Trauma was a more frequent etiology in BiBPPV compared to unilateral BPPV (OR: 8.9).

Conclusions:

• CRM demonstrates high efficacy in treating BiBPPV, with success rates comparable to those for unilateral BPPV.
• A recommended treatment approach involves addressing the more affected side first, followed by the contralateral side.
• CRM is a well-established and effective treatment for bilateral benign paroxysmal positional vertigo.